Anterior Cruciate Ligament Reconstruction Focus of Clinical Trial

It is hoped that the results will help researchers to understand how ACL injury and treatment affect the way the knee functions during everyday activities, and evaluate the benefits of different treatment options for restoring normal function.

McGowan Institute for Regenerative Medicine faculty member Freddie Fu, MD, Chairman of the Department of Orthopaedic Surgery at the University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Distinguished Service Professor, David Silver Professor and Chairman, Division of Sports Medicine, and Professor within the Schools of Health and Rehabilitation Sciences, Education, and the Swanson School of Engineering, along with James J. Irrgang, PhD, PT, ATC, Director of Clinical Research, Department of Orthopaedic Surgery, and Scott Tashman, PhD, Associate Professor, Department of Orthopaedic Surgery, Orthopaedic Biodynamics Laboratory, are co-principal investigators of the first NIH-supported randomized controlled clinical trial in the University of Pittsburgh Department of Orthopaedic Surgery’s history. The NIH grant, in the amount of $3.2 million over a 5-year period, will compare anatomic single-bundle versus anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. The successful completion of this study will provide a clear justification of the role of single- and double-bundle ACL reconstruction to restore knee function and will improve understanding of how knee kinematics after ACL reconstruction contributes to the development of post-traumatic knee osteoarthritis.

The ACL is the most commonly injured ligament in the knee leading to surgery. The ACL is the main stabilizer of the knee and perhaps is most known as a ligament commonly torn by athletes. Each year, most of the 200,000 ACL reconstructive surgeries performed produce successful outcomes initially; however, long-term studies have shown that 60 to 80 percent of patients will end up with joint instability and osteoarthritis within 5 to 7 years after surgery.

The goals of treatment after ACL injury are to restore stability and function to the injured joint, and to prevent further knee damage or deterioration (such as arthritis). However, the anatomy and function of the ACL are complex, and there are many options for treating this injury. The purpose of this research study is to compare dynamic knee function in three groups of individuals who have received different types of treatment--

- Group 1 will include individuals with ACL tears who have been treated with rehabilitation only (no reconstruction surgery).
- Group 2 will include those who have undergone ACL reconstruction using a single graft to replace the torn ligament.
- Group 3 will include those who have undergone double-bundle ACL reconstruction, which uses two separate grafts to replace the ACL.

It is hoped that the results will help researchers to understand how ACL injury and treatment affect the way the knee functions during everyday activities, and evaluate the benefits of different treatment options for restoring normal function. In addition, this study will serve as a basis for designing future studies and may provide information that may help to improve the treatment of ACL tears in future patients.